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Grief

 

Five Stages of Grief

griefThe Kübler-Ross model describes, in five discrete stages, the process by which people deal with grief and tragedy. Terminally ill patients are said to experience these stages. The model was introduced by Elisabeth Kübler-Ross in her 1969 book On Death and Dying. The stages have become well known, and are called the Five Stages of Grief.

Enumeration of stages
The stages are:

  • Denial : The initial stage: "It can't be happening."
  • Anger : "Why ME? It's not fair?!" (either referring to God, oneself, or anybody perceived, rightly or wrongly, as "responsible")
  • Bargaining : "Just let me live to see my son graduate."
  • Depression : "I'm so sad, why bother with anything?"
  • Acceptance : "It's going to be OK."

Kübler-Ross originally applied these stages to any form of catastrophic personal loss (job, income, freedom). This also includes the death of a loved one and divorce. Kübler-Ross also claimed these steps do not necessarily come in order, nor are they all experienced by all patients, though she stated a person will always experience at least two.

Others have noticed that any significant personal change can follow these stages. For example, experienced criminal defense attorneys are aware that defendants who are facing stiff sentences, yet have no defenses or mitigating factors to lessen their sentences, often experience the stages. Accordingly, they must get to the acceptance stage before they are prepared to plead guilty. 

Additionally, the change in circumstances does not always have to be a negative one, just significant enough to cause a grief response to the loss (Scire, 2007). Accepting a new work position, for example, causes one to lose their routine, workplace friendships, familiar drive to work, even customary lunch sources.

Grief

In popular culture these stages are almost exclusively applied only to news of one's own impending death. The notion that to resolve grief they must all be followed, in order, is also common.

Although, in 1974, "The Handbook of Psychiatry" defined grief as "...the normal response to the loss of a loved one by death," and response to other kinds of losses were labeled "Pathological Depressive Reactions," this has become the predominant way for counselors and professionals to approach grief, loss, tragedy and traumatic experiences.[1]

Further, many psychiatrists believe real grieving begins after the stages are over, and that "grief work", involving its own set of stages, begins with acceptance, where the Kubler-Ross stages end.

Research on the theory

A February 2007 study of bereaved individuals, from Yale University obtained some findings that were consistent with the five-stage theory and others that were inconsistent with it .

Criticism

The original Kübler-Ross model did not identify five stages of grief. It identified what Kubler-Ross called "the Five Stages of Receiving Catastrophic News". There exists no real evidence that stages are present in coping with death: Using the terms stages implies that there is a set order of set conditions, meaning that everyone will go through each stage at the same time while confronting impending death. The order of the stages, as well as the amount of time each stage lasts can vary. Also, the definition of each stage is not clear, and some stages can be combined.

More specifically, there is no real evidence that people coping with their impending death move through all of the five stages. The path through the stages is not a one-way street: they can repeat, occur out of order or not at all. It is highly dependent on other qualities, such as emotional ties to family, and other relationships. These stages can also occur in a repetitive, spiral-like fashion where the individual is re-working and re-experiencing various grief stages over time. "Real events", such as moving, getting rid of the loved ones clothing or objects, etc. tend to trigger a grief regression in which the grieving individual may re-experience anger or shock or depression.

The way in which the particular loss is experienced may strongly influence how grief is played out. A sudden loss or violent loss in which one is "blind-sided", caught unaware and unprepared, may create a traumatic loss which is probably more difficult to process and work through.

 

What is Grief?

When someone experiences a loss, they go through a normal process called grieving. Grieving is a natural and expected process which, over time, can allow a person to accept and understand their loss. Grieving involves feeling many different emotions over a period of time, all of which eventually help the person to come to terms with the loss of a loved one. 

Bereavement and mourning are two other words that are commonly used to describe the grieving process. Bereavement is what a person experiences when someone close to them dies. It is the state of having suffered a loss. Mourning is the expression of one's loss and grief. Mourning includes behaviors and rituals that are specific to each person's culture and religion.

Phases of Grief

Many people think of grief as a single instance or very short period of pain or sadness in reaction to a loss -- for example, the tears shed at a loved one's funeral. However, the term grieving refers to the entire emotional process of coping with a loss. Normal grieving allows us eventually to let a loved one go and continue with our lives in a healthy way. Though grieving is painful, it is important that those who have suffered a loss be allowed to express their grief, and that they be supported throughout the process. Each person's way of grieving for a loved one will be different. The length and intensity of the emotions people experience will also vary from person to person. 

It is normal for people to feel better for a period of time, only to become sad again soon afterward. Sometimes, people wonder how long the grieving process will last for them, and when they can expect to experience some relief. Although there is no one answer to this question, it may help to know some of the factors that can contribute to the intensity and length of grieving. The kind of relationship you had with the person who died, the circumstances of their death, and your own life experiences will all play a part in determining your individual grieving process.

Researchers have studied grief to better understand the ways that people work through a loss and eventually accept it. They have identified several phases, or emotional states, that people can experience while grieving. The first phase involves a period of shock or numbness. This phase is often followed by a period of emotional upheaval, which can involve feelings of anger, loneliness, disbelief, or denial. The final phase of grief is the one in which people find some way to come to terms with the loss.

Support:

Additional Resources

Candlelighters Childhood Cancer Foundation 
Telephone: (800) 366-2223 

National Hospice Organization 
Telephone: Hospice Helpline: (800) 658-8898
 
Parents Without Partners International, Inc. 
Telephone: (312) 644-6610

The Compassionate Friends 
Telephone: (630) 990-0010